CMS Formulary

Displaying 123601-123610 of 1611142 results.
ID: 123601
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197464
NDC:
Tier Level: 3
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 123602
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197436
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 123603
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197437
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 123604
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197438
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 90
Qty Limit Days: 30
ID: 123605
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197439
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 60
Qty Limit Days: 30
ID: 123606
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1298861
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123607
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 1298870
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123608
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 314034
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123609
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 198284
NDC:
Tier Level: 3
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 123610
Formulary ID: 00021051
Formulary Version: 15
Contract Year: 2021
RXCUI: 197316
NDC:
Tier Level: 4
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0